Medicaid State Plan ASD Services
A therapy to improve skills through focus on increase of positive behaviors and decreasing negative behaviors. Can help in many areas such as social skills, communication, academic skills and daily living skills.
Child must be enrolled in Medicaid / have a professional diagnosis of autism spectrum disorder and complete an annual Medicaid wellness visit.
- Applied Behavioral Analysis (ABA) Service policy and procedures (July 2025)
- Fact Sheet: Medicaid Autism Applied Behavioral Analysis Service (Updated January 2019)
Autism Spectrum Disorder birth through age 20 Waiver
The focus is to help families care for their child diagnosed with autism spectrum disorder at home.
This waiver looks to the parents to decide what their family can or cannot do and the parents identify what it will take to be able to keep their child at home.
Parents with the help of their team (family, professionals and others) decide which waiver services will assist their child.
- Application - N.D. Autism Waiver
- North Dakota's current Medicaid Autism Spectrum Disorder Birth through Age 20 Waiver (Effective Nov. 1, 2025)
Waiver Services
Items/ equipment to help a child be successful with doing daily tasks. The item can be to increase, maintain or improve what the child is able to do for themselves.
Such things as:
- Three-sided toothbrush to be able to brush teeth successfully on their own.
- Weighted blankets to calm down.
- Bubble light to help fall asleep.
To receive this service:
- Care Plan must state need and goal of item.
- Letter of Recommendation from a professional working with child on the goal.
- Letter must have:
- Items being requested
- Statement of how item will meet need
- Trial of item to ensure it will meet the need and be used.
Provides an opportunity to try wide variety of group activities to build relationships and support in the community where the child lives. May provide one on one staff to assist with participation.
Must be:
- Listed on care plan
- Parents provide transportation
Groups must be:
- Typical activities within community
- Interact with non-disabled peers
- May provide one on one staff to assist with participation
Cannot be:
- One-time events such as concerts, professional games, movies
- Soley instructional led /private instructions = drivers education / music lessons
Assistance in quickly finding a child with elopement behaviors by having a device attached to child’s clothing. Service allows a child to experience more independence in daily schedule, increase inclusion while at same time providing parents with ability to locate if elopement occurs.
Must be:
- Listed on the care plan
- Must have a restriction plan within care plan
- Individuals must have active elopement behaviors
A service to assist a family in gaining access to waiver services and other Medicaid state plan services as well as medical, social, educational and other services regardless of the funding source for those services. Service is provided by phone, home visits (min of 2 per year) or where parent request to meet.
Assistance can be:
- Support to parents in understanding services
- Care plan development
- Completion of authorization for services
- Helping identify community services that will meet goals
This gives parents a break from the daily stress of caring for a child with special needs. It’s an extra set of hands so parents can rest, catch up on housework, run errands, go to another child’s activities, spend time with friends or take a short break. Respite care can be provided either through an agency or by self-direction and it happens right in a child’s home. Transportation is not included.
Family hiring a respite care worker must:
- Have a child enrolled in the state’s Autism Spectrum Disorder waiver
- Have respite care listed on the child’s Person-Centered Care plan
- Be enrolled with Veridian, the fiscal agent that helps families with payroll and criminal and abuse background checks
To be a respite care worker, you must:
- Care for a child who is active on the state’s Autism Spectrum Disorder waiver
- Be 18 or older
- Live outside of the child’s home
- Pass criminal and abuse background checks
For more information on respite care, email dhsautism@nd.gov.
Children with Medically Fragile Needs Service (Medically Fragile waiver)
The purpose of this waiver is to help families who require long term support and services to maintain their medically fragile child in the family home setting while still meeting their unique needs.
Families have access to funds up to $25,300.00 for waiver services with the focus of maintaining their child within the home. Case management is not included in these funds.
Families have access to a Fiscal Agent to assist with management of funds within waiver guidelines and limits.
Waiver Services
Family must also be enrolled in Fiscal Agent for payment of services.
Enable individuals to access essential community resources/services in order to maintain themselves in their home and community and would not be seen as a natural parent responsibility. These are non-medical needs: banks, grocery store, shopping within community.
Limitations
- A replacement for parental responsibility - to school / work for minors
- For medical appointments to include dentist, therapy
- Must not be covered by Medicaid
Additional help when the child receives up to 51 percent of his/her nutrition from supplements or the supplements are disease specific.
Limitations
- Must not be covered by Medicaid
- Must be part of medical management
- Must be scientific established be a medical evaluation
There cannot be such products as herbs, botanicals or products that have no or little scientific bases has been established.
These can only be those products that have been prescribed for the specific dietary management of a disease or condition with distinctive nutritional requirements.
Addresses needs related to stress associated with the care of child, when child is not present for the session. Can be completed on an individual bases or with whole family when identified individual is not present.
Limitations
- Not provided by a psychiatrist or psychologist.
- If identified individual is present then Medicaid state plan is responsible for service.
Temporary relief/ assistance for the primary caregiver, within the home, by a care giving assistant.
In-Home support worker must be
- Be 18 years of age or older
- Live outside of the child’s home
- Pass criminal and abuse background checks
A service to purchase adaptive devices and supplies that can assist a child to stay home and promote independence.
Limitations
- Must not be covered by Medicaid
- Supplies are in excess of Medicaid State Plan limits
Ability to modify home and/or vehicle for more independence of individual.
Home examples
- widen doorways for accommodation of wheelchair
- wheelchair ramp
- modify bathroom to allow individual independence
- grab bars, widen doors, change to accessible shower, change facets to encourage independence
Vehicle examples
- Chair lift
- Interior modifications to allow space for equipment
- Modifications to vehicles to encourage independent driving for individuals to legally drive
Limitations
- Must not be covered by Medicaid
- Not for routine home maintenance
- Adaptations that add to the total square footage of home are not allowed
- All modifications must be in accordance with state and local building codes
- Vehicle must be owned by legally responsible caregiver
- Vehicle must be licensed and unsured within North Dakota
- Modifications must meet manufactories’ installations specifications.
Temporary relief for the primary caregiver. Care provided in a nursing facility or hospital which can meet the child’s unique medical needs while the primary caregiver is away.
Limitations
- Must not be covered by Medicaid
- Length of stay will not exceed 14 consecutive days.
- Must be arranged by legally responsible caregiver.
A service to assist a family in completing case plan, emergency plan, and support to family as needed. Service may consist of phone calls or accompanying to additional support agency to assist with understanding of services and responsibilities.
Case Management service would meet face to face with individual / family at least quarterly; this would include:
- Review of progress
- Satisfaction of services
- Identify barriers and
- Discuss an action plan to resolve outstanding issues
- May attend IEP meeting is parent requests to support
Case Management service is not considered as a monthly service to remain on the waiver.
For Public Information - North Dakota Statewide Transition Plan
North Dakota Cross Disability Advisory Council
Learn how North Dakota is improving access to services for children with disabilities.
Contact
Katherine Barchenger, Children's Waiver Administrator
North Dakota Health and Human Services
Medical Services Division
600 E. Boulevard Ave., Dept. 325
Bismarck, ND 58505
Phone: (701) 328-4630
Toll-Free: (800) 755-2604
711 TTY
Fax: (701) 328-1544
Email: dhsautism@nd.gov